End-of-life practice in Belgium and the new euthanasia law

Excerpt

End-of-life decisions are taken by physicians every day in hospitals, care facilities, and at home. A study performed several years ago in Belgium [1] which reviewed some 4,000 death certificates reported that death was unexpected in one-third of the cases, but that an end-of-life decision was made in 39.3% of the deaths. More recently van der Heide et al. [2] studied records of 20,480 deaths in six European countries (Belgium, Denmark, Italy, The Netherlands, Sweden, and Switzerland) and found that the proportion of deaths preceded by an end-of-life decision varied between 23% (Italy) and 51% (Switzerland), with Belgium at 38%. These end-of-life decisions include withholding or withdrawing treatment and in some cases alleviating pain with opioids, even when it is suspected that this may shorten life. Deliberate drug administration with the explicit intention of shortening patient life is also widely practiced across Europe, with one study reporting that 57% of Belgian intensive care unit (ICU) physicians, compared to an average of 40% across Europe, said they sometimes deliberately administer large doses of drugs to patients with no hope of a meaningful life, until death ensues [3]. …